M\inister of Health Dr. Duane Sands said yesterday a new fee structure will generate approximately $40 million in annual revenue to Princess Margaret Hospital (PMH) when implemented.
“We have had preliminary estimates that if we are able to bill efficiently that we can increase our annual revenue by an additional $40 million or more,” Sands said.
Sands announced the changes in late December, noting that there were more than 500 recommended changes to the present fee structure.
After some pushback when part of the new fee structure was announced, Sands noted that the PHA was on track for a $50 million to $60 million deficit, and the changes were going to happen.
Sands said revenue would go toward improving patient experience, improving equipment, supplies, and upkeep of the hospital.
When asked whether he had a timeline for implementation of the structure, he said: “Whenever we get it right. Whenever we accomplish the goal that we have and that is to achieve a progressive means of increasing revenue for the hospital.”
Sands said the government is still figuring out exactly how to implement the structure.
“It’s a matter of determining how you make it happen,” he said.
“How do you legally get access to this revenue? How do you undo policy that has been longstanding?
“This is intertwined with a number of union agreements and whether or not we have to renegotiate these agreements and so on and so forth, so a principle has been agreed. We know that we do not wish to put more of a burden on people who could least afford it but at the same time, there is legitimate revenue that the hospital ought to be able to get.”
Sands said since 1988 PMH has lost $786 million in uncollected revenue for not billing all of its patients.
He said some insurance companies do not pay patient bills because the hospital is unable to generate proper bills for the company to evaluate.
“The requirements for billing an insurance company in The Bahamas now requires that the service is coded with [Current Procedural Terminology] and [International Classification of Diseases] codes, that there is an attached dictated summary, an itemized bill, and verification that service provided was reasonable and customary.”
Sands added that PMH is very rarely able to generate “much more than an operative report”.
He said the government has to address structural issues within the hospital, such as being able to access patient records within a timely manner, in order to successfully implement this system.